The Art of Palpation:

Sensing Inflammations through a Wooden Stick

Jens Anders Kjersem, DC

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Table of Contents

Foreword by the Author ……..………………………………………….……page 3

Preface …………………………………………………………………………………page 4

Introduction …………………………………………………………………………page 8

Research, Palpation, and Pain ………………………………………………page 11

Observing Subluxations …………………………………........................page 16

The Cloaked Sense ……………………………………………………………….page 21

Using a Wooden Stick …………………………………………………………..page 23

Conclusion …………………………………………………………………………….page 26

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Foreword by the Author

As the author of three books, Learn to Heal, Another Wonderful Day and Proving Chiropractic, I have

been in doubt about presenting this material because it may be perceived as wrong or inaccurate to others,

possibly also irrelevant. However, after testing the clinical use of a wooden stick for many years,

including how the stick may be used for displaying tissue swelling by making a mark imprinted in the

skin by an indentation from the pressure of said wooden stick, I have decided that in this particular

publication about palpation, it could be the right time to present the allegation regarding the likelihood of

sensing inflammations through a wooden stick.

In general medical and hospital practices, it is common to leave a mark in the skin from the pressure of a

fingertip, as the display of such an imprint temporarily remaining in the skin demonstrates the presence of

tissue swelling. In chiropractic practice, an indentation in the skin staying longer than normal will also

generally indicate swelling, which is one of four cardinal signs of an inflammatory lesion. Such swelling

may be found superficially in or around affected articulations but usually derives from lesions slightly

deeper in the connective tissue of articulations, indicating that there is a lesion from overloaded tissue

related to the articulation, destabilizing it, and causing subluxation. However, such swelling may also

derive from much deeper lesions, like bulging or herniated cartilage discs located four to five centimeters

into the body. Nevertheless, making a mark (indentation) in the skin is quite easy to do and a good way to

display any cloaked inflammatory reaction.

The technique of using a wooden stick should be interesting for chiropractic physicians, whether it is used

for finding specific inflamed tissue of subluxations by making an indentation into the edema of the skin or

simply by sensing inflammations through a wooden stick. If you are in doubt about whether a person can

sense inflammatory reactions in tissues through a wooden stick (or even a plastic pen), then blindfold a

test person, or better yet, test yourself by closing your eyes and observing if you are able to, over and over

again, find the same exact point on the skin where a tiny inflammatory reaction is located underneath.

The author wishes that the rather new and controversial aspects of sensing inflammations through a

wooden stick may be investigated by evidence-based research in the future.

Ålesund, Norway, October 9th, 2015

Jens Anders Kjersem, DC

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Preface

The primary reason for publishing this booklet on The Art of Palpation is to teach chiropractic physicians

and students some new and very special advantageous techniques in palpatory examinations. The

information in the booklet may be converted into practical use in chiropractic practice and improved by

clinical training on using a wooden stick. It may seem like suggesting sensing inflammations through a

wooden stick is somewhat off the wall or even crazy, but as of the time of writing, the author has been

practicing for nearly 47 years and for more than the half of that time, objects such as a wooden stick,

plastic pen, etc. have been used for singling out the sensation of inflammation from the many other

sensations perceived through ordinary palpation with fingertips.

A huge number of patients have been examined during the author’s long time in clinical chiropractic

practice, and with such extensive clinical experience his opinions should count in his favor, as they are

based on solid empirical knowledge from serious investigations in clinical examinations. Therefore, read,

listen and learn from this booklet on The Art of Palpation and start practicing sensing; it will be worth it.

Whether worn, ruptured tissue fibers (lesions) are deep or more superficial, they will all be related to

inflammatory reactions, generally referred to as “subluxations” by chiropractic physicians. A subluxation

may be defined as a small dislocation, which is actually smaller than a luxation (dislocation). Most

subluxations are so small that they cannot be physically observed, and they are usually simply like a part

of the curvature created by asymmetric muscle tension and contractions.

It is the asymmetry of muscle tension and contractions in inflamed connective tissue related to affected

articulations that normally make up subluxations. If such asymmetry resides too long without healing

properly (becoming straighter), both any asymmetric curvature as well as subluxation may settle in the

tissue and heal as it is (more or less chronic irritation) with fibrosis, generally after first going through the

stage of fibrositis. It is indicated that fibrotic healing over long periods of time in general will lead to

degenerative conditions with articular calcifications. Thus, the earlier subluxations are restored to normal,

the better they will heal.

The question is: Where do subluxations with inflammatory reactions come from? The answer is:

Subjective clinical experience indicates they all come from tissue damage of tiny or large overloads of

rupturing tissue fibers. Such damage may be the result of sudden accidents or awkward or trivial

movements with twisting or bending but also quite often the result of working positions (e.g., heavy

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lifting). However, most of the time the tissue damage is small, but such small subluxations may also

produce nervous dysfunction, especially in the sensory nervous system. Small subluxations will generally

derive from long-term or frequently repeated postural positions in leisure, normal work, or both. In the

spinal canal, bulging or herniated discs may take ten to twenty years to gradually develop. However, all

of the aforementioned causes may of course result in tissue damage, producing inflammatory reaction and

thereby subluxations, which are palpable due to their inflammatory reactions.

Homeostasis in the body seeks to maintain proper functions in all tissues of the body. Against tissue

ruptures, homeostasis will usually respond by producing palpable inflammatory reactions; these are a

natural healing response of the immune system. Still, inflamed tissues are weaker and more vulnerable to

further injury, and therefore homeostasis will also produce articular immobilization, which is a muscular

contraction around an injured tissue, in an attempt to reduce stress on the inflamed tissue fibers. Reduced

motion around the damaged tissue will of course protect the damaged tissue against further injury.

However, such muscular contractions will generally match the greatest strain to which the ruptured fibers

were exposed. As a result, the degree of immobilization will in general (in most instances) be too great.

The reason that such protective muscular contractions may be too great is that persons with

damaged/injured tissue usually become very careful not to further overload that tissue. Additionally,

when persons are exposed to strain rupturing the tissue fibers, the symptoms of pain will generally cause

them to make more careful movements and to keep their posture straight. They will feel that controlled

movements and keeping straighter posture will give them less pain. This is of course logical, as careful

motion and straighter posture produce less stress and lesser loads on the injured tissue. As a consequence,

affected persons will therefore normally be more careful on their own, and they will not need all of the

protective muscle contractions immobilizing the subluxation. On the other hand, some of the damaged

tissue (subluxation) will still be there but elicit less pain until the natural healing finally reaches a certain

level of health, making the patient feel good and healthy.

Some people with tissue injuries do not seem to get rid of their pain soon enough and they will therefore

seek help from chiropractic care. Chiropractic physicians may then adjust their subluxations and mobilize

them, which will loosen up some of their protective muscular constrictions, making them feel better. Such

adjustments generally relieve some of their pain immediately, and if they move with care and maintain

straighter posture, which also is basic advice given with any chiropractic treatment, they will be able to

avoid unnecessary loads on the affected tissue and they will not experience a relapse. Thus, the results of

chiropractic adjustments in general will lessen pain immediately after treatments, making patients simply

feel better by being able to move better from the adjustments.

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In summary, increased articular motion from treatments creates better circulation, and patients become

more cautious after treatment, improving natural healing in damaged tissue. Patients will also partly lose

some of the muscular constrictions reducing articular motion, protecting the damaged tissue, as less

protection is needed when patients become more cautious after treatment. If patients are not able to avoid

additional loads by being cautious, or the tissue damage/injury is too great, the protective muscular

constrictions will return as a relapse; however, this is a normal homeostatic protective response to too

great of a load. If relapses occur, conditions stay the same or improve only a bit, and chiropractic

treatments have to be repeated, including reminding patients how to be careful with their lifestyles. Then,

when relapses of muscular constrictions around the affected tissue have finally been overcome, continued

chiropractic therapy may still gradually aid the natural healing processes, allowing patients to improve

naturally and gradually after each therapeutic visit. If the chiropractic treatment schedule is interrupted,

which is mostly brought about by the patients them self because he or she feels well enough after a few

treatments, the healing processes may be halted naturally, and the condition may heal as is. The reason for

this type of healing is most likely that tissues heal within certain time spans, as homeostasis seeks to

protect tissues and therefore balance physiological conditions against each other. This form of healing

achieves the best possible health within a certain time and provides the highest possible protection for

tissues against outside forces. Thus, when patients do not conform to the lifestyle recommended to take

care of their health, healing with a certain pace, they will heal as is and may end up misshapen in a

“crooked” manner. Such crookedness may create easy spots for tiny inflammations in their

musculoskeletal systems. There are many indications pointing to the notion that this type of healing is

most likely the reason why so many people acquire degenerative joint diseases and grow old with

crooked, degenerated postures. However, whether or not they have said crooked posture, the wooden

stick may be used on them and help improve their health.

Many patients heal naturally on their own without chiropractic treatments, but this type of healing will

often take a longer time, and time is of the essence if persons with subluxations want to heal properly and

optimally aligned. Today, it is a physically proven fact that chiropractic therapy aligns postural balance

with proper chiropractic treatments. This fact may be demonstrated through a clinical spirit level

measuring postural balance against the force of gravity. When healing without chiropractic care, some

persons may therefore develop scoliosis due the healing of crooked shapes in poor alignment. It is also a

well-known fact that people with crooked structures (scoliosis) commonly acquire degenerative

calcifications, stabilizing their crooked curvatures after a period of time.

*

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Loosening the protective muscular constrictions with chiropractic adjustments to increase mobility and

circulation may in general be done by techniques of hands-only chiropractic adjustments. However, it

may often be done more efficiently with the Trigger Point Hammer (TPH) and the TriggerCiser (TC).

When using these instruments with stamping mobilizing thrusts against a particular part of a bone in a

subluxated articulation for about 30 seconds, the stamping percussive thrusts will loosen some of the

protective muscular constriction, and patients will generally always feel much better afterwards. When

holding such an instrument in hand, the mobilizing effects of the arm movements will increase mobility

and circulation, while the percussive effects of the mechanical thrusts of the instrument will create

increased circulation in the deeper tissues.

After the mobilizing and percussive therapy with an instrument (TPH/TC) for 30 seconds against a

precise part of a particular bone/articulation, the treated tissues should have about a 2–3 minutes rest for

convalescence (response time), as the circulation in the treated tissues generally always needs such time

to respond with increased circulation in order to make the patient both feel better and heal better.

The basic reason for treatments with the percussive instruments no longer than about 30 seconds at a time

against a particular anatomical area is that soreness may occur. Also, 30 seconds is usually enough time

for the mobilizing and percussive effects to loosen up the homeostatic protective muscular constrictions

and increase articular motion. Additionally, 2–3 minutes of response time will usually be enough time to

enable increased circulation and make patients feel better in general.

The efficiency of these instruments (TPH/TC) is generally great, and most patients normally feel much

better immediately after such percussive therapy; though, there is one catch: Treatments must be

delivered precisely against the subluxated bone. Still, chiropractic physicians will be assisted in that

endeavor by using a wooden stick properly. (Besides, they may also sense inflammations through the

percussion instruments; however, these instruments are not very efficient for making indentations in

edematous tissue.)

When using the TPH or the TC for specific directional mobilizing and percussive treatments, the wooden

stick is quite useful for finding the precise location of the affected (inflamed) tissue, as diagnosing with a

wooden stick can be done at the exact location of tissue inflammations, indicating the precise point of

contact for the tip of the percussive instrument. For this reason, it is recommended to always use a

wooden stick when diagnosing subluxations for therapy with the TPH and the TC. On the other hand, if

normal tissues happen to be treated, they will neither worsen nor improve but respond naturally as to any

other outside force.

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Introduction

Palpation is the practice of using the hands to examine tissues in the body and through such palpatory

examination mentally perceive and diagnose a disease or an illness. Palpation was mentioned in the works

of Hippocrates, but as a form of examination it was not commonly used until the second half of the 19 th

century. Palpation is based on tactile perception when moving and pressing the fingers or palms of the

hands against tissues. It may be either superficial or deep. Superficial palpation may be done both with

the fingers and the hands touching the skin of joints, the chest, or other parts of the body; then again,

blood vessels may be palpated with just the fingertips to determine their fullness and condition. Deep

palpation may be performed by more specialized methods for individual organs, recognizing abnormal

conditions of the stomach, intestinal tract, liver, spleen, kidneys, rectum, vagina, etc. Although medical

palpation for the most part is used for examining abdominal organs and thoracic chest, it is also used for

diagnosing edema and measuring the pulse rate. Veterinarians, on the other hand, principally use

palpatory examination for pregnancy, and midwives use it during pregnancy to determine the position of

a fetus.

The performance of chiropractic palpation is only slightly different from medical palpation, as it is mainly

carried out by the fingertips, which feel and sense abnormalities of tissues in or on the body, creating a

mental picture of any abnormal tissue conditions while determining the shape, size, tissue consistency

(firmness, tone, elasticity, range of motion), swelling, heat, and pain. The latter three signs will help in

finding (observing by the sense of seeing) the exact location of abnormal objects and conditions.

Although chiropractic physicians also may observe superficial redness of the skin from inflammatory

reactions in the tissues underneath when irritating the skin during examinations, they will mostly rely on

the touch of palpation during diagnostic examinations.

In chiropractic palpation, the mental perception of abnormal conditions is generally attained from the

basic diagnostic signs of inflammation in the tissue, but motion palpation of articulations is also common.

Both methods are basically why all chiropractic physicians perform palpatory examinations on every

patient, but all palpatory examinations should include assessment of muscle tone, quality of tissue

elasticity, range of articular motion, and degree of tissue tenderness. Although palpatory examinations are

quite subjective and prone to error – at times even difficult to reproduce, they will as a general rule

always help chiropractic physicians in establishing the presence of an inflammatory reaction with

swelling, redness, heat, and pain (the four cardinal signs of inflammation) in affected tissues.

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For chiropractors and chiropractic students, the palpatory provocation of pain done with pressure or

stretching is the most important diagnostic method in clinical chiropractic practice. Palpation done by

chiropractic physicians to determine the locations of painful anatomical regions as well as the extent of

pain felt by patients have a common interest in general practice, as both doctors and patients want to get

rid of pain. Physicians need to make a palpatory diagnosis of the painful tissues to perceive the location,

extent, and reason for the pain; this is basic in chiropractic diagnosis in order to be able to treat patients

properly. Therefore, palpation of painful tissues and perceiving information through the sense of touch is

the most important way for chiropractic physicians to identify the state of health in affected tissue.

The diagnostic performance of palpation is in every respect a highly individual ability, which may be

developed in the same way as any other personal skill. Whether the use of senses concerns playing an

instrument, the drums, or simply developing a good sense for tissues palpation, it must be made clear that

any inborn hereditary ability to sense conditions of affected tissue is simply a mere small part of the basic

skills of palpation. Additionally, the performance of chiropractic adjustments, which is based on the skill

of palpatory sensations, also has to be developed; no one is born to deliver great chiropractic adjustments.

Consequently, when chiropractic students are training themselves in palpating human tissues by the touch

of fingertips and delivering chiropractic adjustment, both abilities require the proper sensing of

inflammations, which are caused by the natural repair processes of the immune system healing damaged

fibers. Thus, as adjusting skills are highly personal skills like palpation skills, the techniques of adjusting

bones/articulations also need to be developed by practicing over and over again; they have to be practiced

just like most other individual physical performances.

The ability to perceive palpatory information may be trained in the same way as listening through a

stethoscope to the sounds of the heart or the breathing in the lungs. It is therefore important that

chiropractic students start palpating each other early on, preferably as freshmen and continue with this

clinical training throughout their time as chiropractic students, and also into clinical practice. After their

clinical training period (at the end of their chiropractic education), they need to continue developing their

skills of palpation in order to become efficient chiropractic physicians. Each chiropractic physician will

generally develop their own personal palpation skills in order to become optimal at sensing affected

tissues with inflammatory responses.

As subjective palpatory information attained from sensations in the fingertips is individually perceived,

the sensations cannot easily be scientifically evaluated. However, all senses seemingly work together,

letting us extract a variety of information from sensing affected tissues. The sense of touch (palpation)

works individually in every person, and some persons will become better than others at identifying what

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they truly palpate in affected tissues. Others, on the other hand, will have greater difficulties with their

palpation skills and have a hard time mentally perceiving what they truly sense. Thus, it must be clear that

the information perceived through our senses is highly personal and only much clinical training will

produce the best information.

The five senses – see, hear, taste, smell, and touch – may all be used in various ways, but by combining

them, they will provide a variety of information, and therefore the ability to see where we touch provides

us with better specificity of an anatomical location. Then again, finding additional cooperating senses in

our body is not really difficult. We may simply place a blindfold over our eyes and let the vestibular fluid

of our inner ear tell us our relationship to Earth’s gravity, or let us feel a car’s acceleration, or even notice

sea sickness on a boat. However, there are also other senses, like hunger, thirst, and the sense of pressure

within the bladder bringing us to the bathroom. As these senses and others will leave us thirsty, hungry,

tired, restless, or even in need of a restroom, they cannot be ignored.

By understanding the aforementioned, and, for example, by recognizing how blood pressure and blood

sugar levels are regulated in the human body, we may conclude that our physiology consists of a

multitude of senses, all of which are not noticeable to us and some possibly also unknown to us.

Certain conditions act as senses and trigger autonomic undetectable signals. These are not clearly

perceptibly to us, but they are certainly clearly interacting with the world around us. These interactions

rely on physiological control mechanisms that are very different from the five common senses. They are

more autonomic senses and are therefore classified under categories other than the five special senses,

which have specialized organs devoted to them and therefore are normally defined in neurology as “the

five special senses.”

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Research, Palpation, and Pain

A Norwegian research team at Uni Research Helse in Norway found that in most cases there are usually

no disorders connected to ordinary back pain problems, concluding that back pain simply happens as a

part of normal life. Hence, by this statement, the team concludes that there are no disorders, which may

be palpated, when people have back pain. The researchers, PhD Candidate Eline Ree and Researcher

Torill H. Tveito, claim that giving advice regarding caution to people with back pain will have little or no

effect. Ree and Tveito’s research tells them that people with back pain do not have to be careful; it is a

waste of time. Furthermore, the team’s research also indicates that any form of activity/motion is good for

people with back pain, as no significant number of people get better whether or not they follow advice

about being careful.

In chiropractic circles, the presentation of the aforementioned “facts” are surprising because chiropractic

physicians know from ordinary chiropractic research that chiropractic treatments, including dispensing

advice about caution, help people with back pain – generally instantly. In addition, chiropractic

physicians also know that chiropractic treatments primarily concern adjusting subluxations (tissue

lesions) and that such lesions are related to inflammations. Therefore, as inflammations are related to

disorders with damaged tissue, people with back pain have disorders. This fact may be confirmed by

palpable inflammations and also physically demonstrated by making lasting indentations remaining in the

edematous tissue of tissue lesions (disorders/subluxations/inflammations). Thus, contrary to the

statements of the Norwegian researchers, simple chiropractic examinations may affirm that inflammations

are always present in people with back pain, as said inflammations always display the four cardinal signs

of inflammation, swelling, heat, redness, and pain. Conclusively, the tissue lesions (subluxations)

producing back pain may be both palpated and physically observed by an indentation in the edematous

tissues because of specific diagnostic symptoms from the four cardinal signs of inflammation. In addition,

their subluxations (lesions) may be treated with chiropractic adjustments, instantly reducing back pain in

most people.

The sudden relief of some of the back pain is generally believed to take place because the immediately

responding postural balancing reflexes improve articular motion and loading conditions in the posture.

However, the actual healing processes of the damaged tissue will take a longer time. In fact, tissue lesions

producing back pain will in the long run have to heal naturally, using approximately the same time for

final healing as any other untreated tissue lesion. Thus, a perfect cure for back pain taking over natural

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healing processes does not exist, as suggested by the researchers; moreover, such a perfect cure will

probably never exist, as natural healing needs a certain length of time to finally heal tissues properly.

There is a difference in the healing of tissues in people receiving chiropractic treatments from those not

receiving such treatments. This difference can be explained as such: A broken bone will still heal within a

certain time if the fractured ends of a bone are not set properly in place. The same will happen to poor

postural curvatures; they will also heal as is if chiropractic treatments do not align postural balance

properly. The reason is that normal healing protects tissue whether tissues become crooked or not, and

similar tissue lesions will need a similar time to heal damaged tissue fibers. Therefore, crooked curvatures

will generally heal as is and adapt to the various new body functions and eventual new anatomical shapes,

just like a broken bone healing crookedly.

What is apparent about the aforementioned Norwegian researchers is that they failed to observe the

simple but important changes in lifestyle that took place among most of their subjects with back pain. The

changes in lifestyle were directly concerned with the effects of advice about caution and normal

activity/motion among those who had back pain. The failure to observe this therefore affected the

researchers’ back pain research, as it made them unable to scientifically compare the two groups in

question, people with or without back pain, as equal groups. The group of people who had back pain

would therefore have different lifestyle manners of activity/motion/caution than those without back pain,

whether from natural inclination or having been given as advice. By becoming alert to the fact that proper

posture and good activities reduce back pain, being cautioned about their postural balance and daily

activities would therefore affect the healing of their back pain.

The absurd and illogical statement that there are generally no disorders present in most cases of back pain

– when visible swelling as a physical sign of inflammation in general can demonstrate otherwise in

tissues of people with back pain, or at least that such swelling may be found in tissue in close proximity to

the tissues expressing back pain – makes chiropractic physicians wonder about the performance of the

researchers at Uni Research Helse in Norway.

Chiropractic physicians have always known that most people who have back pain tend to become extra

careful on their own and therefore keep straighter posture and use careful movements. In fact, it is a

natural tendency for most people with back pain to change their lifestyle by reducing the loads on posture

and using more cautious movements. This tendency takes place whether pain comes gradually over a long

period of time or suddenly by trivial movements or heavy lifting. Assumedly, people with back pain

simply become more cautious because it becomes obvious to them that extra loads produce more back

pain, and lighter loads produce less back pain. In other words, people with back pain simply listen to what

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nature tells them to do, and they will therefore naturally straighten their posture and make more careful

movements in order to feel better. As a group, the lifestyle manners of people with back pain will

naturally reduce postural loads and increase circulation by getting better articular motion, which

stimulates the natural healing processes in affected tissues; as a general rule, people does not do this until

back pain occurs. In scientific research these two groups of people, those without back pain and those

with back pain, are totally incomparable concerning the type of research by the aforementioned

researchers, which conclusively stated that therapeutic advice is completely unnecessary and that any

kind of activity/motion is good for people with back pain. In fact, the researchers stated that avoiding

activity would do more harm than good. However, it is advice like that which may result in more harm

than good, as they are entirely off the mark.

Although most people with back pain feel that straighter posture and cautious movements produce less

pain, there are a few who are not careful. These few may possibly not understand how to be cautious, and

therefore chiropractic physicians give advice regarding cautiousness after treatments. These people

seemingly relapse more often than others, but they are generally few in number and therefore

insignificant. However, these few should probably be researched, as they might reveal unknown aspects

about back pain.

The researchers of back pain at Uni Research Helse did not find any disorders connected to back pain,

and their research showed that most people with back pain in the long run healed naturally from their

back pain whatever physical tasks they did. The Norwegian research team therefore concluded that most

therapies for back pain are generally not needed because people with back pain simply get better

whatever they do. In addition, they also indicated that a good cure for back pain has yet to be discovered,

but they failed to acknowledge that (according to chiropractic research) most patients with back pain

generally always get instant relief from chiropractic care. They also failed to recognize that inflamed

tissues, which were damaged by overload and had ruptured/torn fibers, in the long run would need the

same natural healing time as any other tissue with the same damage. However, if the Norwegian

researchers had acknowledged that painful tissues are due to inflammatory disorders with the physically

demonstrable cardinal sign of swelling, they might not have come to those conclusions.

Those few who keep on irritating their tissues, producing back pain by increased loads and decreased

circulation, will often never heal completely, and therefore they will always have at least a little bit of

back pain. However, as far as their tissues healing, their natural healing time will always depend on the

amount of inflammation (tissue damage) and how they may increase circulation by reducing loading

conditions in their posture. Although most patients feel instantly better and have less pain after

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chiropractic treatments, their affected tissues will in the long run heal completely in about the same length

of time as other tissues. However, the sense of absence of back pain does not mean that the affected tissue

has healed completely, as the pressure of palpation and stretching of tissue may provoke pain if the tissue

has not healed completely.

To a certain degree, the Norwegian researchers may be correct when they say that all types of activity are

good activity. However, there is a fine line between good activity promoting healing and bad activity

hindering healing processes. This fine line is not the activity itself, but rather how it is performed. If

people with back pain want to promote proper healing through good activity, they need to reduce postural

loads. This means that they have to keep a straighter posture, which will make them be able to move more

easily. If they cannot do that, the same activity will end up being a bad activity and hinder healing. Thus,

the same activity may either promote or hinder normal healing processes. As the researchers did not

discover this fine line between good and bad activity, their research on back pain was based on erroneous

premises, which became the invalid foundation for their research.

The fine line between good and bad activity may be found when observing what people actually do before

and after they acquire back pain. If the Norwegian researchers had been observing these activities, they

would have noticed that people with and without back pain perform the same activities but in different

ways. This means that after people acquire back pain, they try to straighten their postures on their own

and move more carefully, which is a good activity as it reduces postural loads naturally; such activity

lessens back pain.

Chiropractic physicians know from clinical experience that any activity is good activity if those with

lower back pain keep on swaying (arching or increasing lordosis) their lumbar spines to maintain straight

posture while performing activities. Most people with lower back pain will do so naturally because it

lessens the pain. Thus, chiropractic physicians should generally tell patients with back pain the following:

“Be careful while doing any activity and try to maintain a sway in your lower back (lumbar spine), as

such sway will not just reduce loads in the lower back, but also in the whole posture because of the effects

of the natural postural balancing responses coordinated by CNS neurons.” When standing upright or

when lying down, patients should be told to maintain normal lumbar lordosis (normal low back sway in

upright position) and that when they sit down or bend forwards, with or without a twisting motion, they

must also always try to create a lumbar lordosis (low back sway) in order to reduce loads on the total

posture since when sitting or bending forwards, the natural upright lumbar lordosis is lost, and straight

postures generally become slouching.

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The lumbar lordosis is produced by natural balancing reflexes, which work incessantly and autonomously

to coordinate all weight-bearing structures in the posture to maintain ideal positions for carrying loads.

Thus, by maintaining a lumbar lordosis, which is a normal curve for people lying down or standing

upright, it will cause the postural muscular balancing reflexes to straighten the whole posture, reduce

postural loads, improve articular mobility, increase circulation, and promote healing processes. Thus,

after delivering proper treatments and giving advice about good activities, the length of time imprints

remain in the edema should indicate the efficiency of these actions after healing processes have reacted

normally, generally within two days.

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Observing Subluxations

Because of palpatory skills, chiropractic physicians may sense inflammatory reactions in connective

tissue related to subluxations and will generally always be able to find the subluxations. They may

clinically identify the presence of subluxations simply by drawing attention to one of the four cardinal

signs of inflammation related to subluxated tissues, namely swelling. By using a wooden stick to make an

indentation (physical imprint) into the edema of the skin just posterior to the subluxation, usually on or

very near the spinous process, but also in tissues where pain is expressed due to the swelling of inflamed

tissue, such an indentation will generally remain in the edematous skin tissue for a longer time than

normal. The longer this indentation stays, the greater the degree of the inflammation. Thus, a subluxation

may actually be physically observed due to the swelling of tissue at a particular location related to a

subluxation and the degree of inflammation may be evaluated by how long the indentation stays in the

tissue. A chiropractic treatment delivered may be evaluated as successful or not by the reduction of the

swelling after two days. Such evaluations are more physical and clearly more objective than the

subjective evaluations of ordinary palpatory examinations using the touching/sensing of fingertips.

Chiropractic physicians may palpate tissues to find the inflammatory lesions referred to as

“subluxations.” By adjusting such subluxations and moving them into new positions, generally from an

outer position toward a more median position, the chiropractic physicians instantly create new weight-

bearing positions for these postural structures. As adjustments create new weight-bearing positions for

postural structures, they also bring on new weight-bearing loads in total postural balance. The effect of

the new loads activates the postural muscular balancing reflexes coordinated by the CNS, which

muscularly rebalances all postural structures in an attempt to maintain postural structures in ideal weight-

bearing positions against gravity.

The postural muscular balancing reflexes work continuously to reduce loads on weight-bearing structures

of postural balance by positioning them ideally according to gravitational loads, which also secur optimal

healing benefits with the best possible tissue circulation, keeping posture optimally balanced over long

periods of time and thereby reducing the possibilities of degenerative reactions that can result in

degenerative joint disease. Said postural muscular balancing reflexes work unceasingly by functioning all

day and night, when the individual is asleep or awake and when running, walking, sitting, or lying down.

In fact, the balancing reflexes function autonomously like the heart and the lungs, always seeking to

achieve the best possible weight-bearing balance for all postural structures.

16

The pelvic structures of the erect posture function in an extraordinary way. These structures carry the

heaviest loads in the body posture when the body is in an upright position, and all structures of the pelvis

(one sacral and two iliac bones) assume optimal weight-bearing positions that are ideal for carrying loads.

As the pelvis is regularly exposed to exceptionally heavy loads when the upper part of the body moves

away from the vertical midline, and these loads are carried principally by the small discs of the lower

lumbar spine, homeostasis has evolved ways to manage this fact by always maintaining the upper pelvic

structures, the transverse iliac crest line (TICL), in an absolutely perfect horizontality.

As the pelvis rigs the supportive musculature for most movements of the upper body in relation to the

midline, and the upper body moves away from the vertical midline over and over again during many daily

activities, the body posture will always assume perfect TICL horizontality as normality. This horizontal

perfection of the TICL takes precedence in all upright humans, even in persons who have disc hernias.

As perfect TICL horizontality is the norm in all erect individuals, it may therefore be utilized as a

reference for normal postural balance. This normal condition (normality) may be measured with a spirit

level against the force of gravity (water level) to see if postural balance is properly coordinated by the

CNS. In other words, the horizontality of the TICL may be measured against water level with a Pelvic

Angle Indicator (PAI) and if this measurement display perfect TICL horizontality, it is plain that the

sensory receptors are transmitting consistent (proper) information to the CNS neurons, making the

muscles controlled by the postural balancing reflexes able to coordinate postural balance optimally and

thereby naturally produce perfect TICL horizontality as normality. Thus, such postural balance is

optimally coordinated and has a properly balanced posture with perfect TICL horizontality.

As homeostasis always seeks to maintain ideal weight-bearing positions for postural structures, these

structures will always be optimally repositioned against the force of gravity after chiropractic therapy.

This repositioning is coordinated in the CNS according to the information transmitted from sensory

receptors located in tissues throughout the body. When postural balance is properly coordinated according

to normal nerve transmissions, the body posture will always assume perfect TICL horizontality.

The sensory receptors register loads in tissues throughout the body, and they transmit information about

all loading conditions to the CNS neurons, which use muscles controlled by the postural balancing

reflexes to coordinate all weight-bearing structures according to the sensory information. However, these

sensors may become disturbed and dysfunctional, especially by tissue swelling, and they may therefore

transmit either consistent or inconsistent information about tissue loads to the CNS neurons concerned

with coordinating the posture. In order to evaluate whether or not the weight-bearing structures have

become ideally positioned within the postural balance, the TICL may be measured with a clinical spirit

17

level, usually a Pelvic Angle Indicator (PAI). This clinical instrument will register the TICL horizontality

and thereby confirm whether or not the TICL is coordinated conditional to normality, which is either

perfectly horizontal or diverging.

When the sensory receptors transmit inconsistent information to the CNS neurons, the neurons will be

unable to ideally coordinate the positions of the postural structures. If this happens, the clinical spirit level

referred to as the PAI may divulge whether or not such dysfunctions exist. By measuring the horizontality

of the TICL with a PAI, this clinical spirit level may simply display whether or not the TICL is diverging,

as with a few exceptions of anatomical and physiological anomalies, a diverging TICL generally indicates

a poorly coordinated posture.

During normal motion, it happens quite frequently that the upper body moves away from the vertical

midline of the body, making the pelvis carry very heavy loads. In order for the pelvis to be able to carry

such heavy loads, the TICL must assume perfect horizontality, which is the most ideal weight-bearing

position for the pelvis. The TICL will therefore always be maintained in absolute perfect horizontality.

Other structures may be given some slack in positioning according to their sizes, shapes, and

functionality; however, the TICL of the upper pelvis will always be coordinated horizontally with

remarkable precision in all upright persons. Thus, when consistent sensory information about weight-

bearing loads are received by the CNS from the tissue sensors throughout the body, the upper pelvis

(TICL) will always assume perfect horizontality. When such horizontal TICL perfection has been

achieved, it is because the total posture and all its structures has changed their positions a tiny bit, making

postural balance able to produce horizontal perfection of the TICL in upright standing position.

Some chiropractic physicians assert that they adjust subluxations in a very specific direction. Although

such specific adjusting seemingly aids the coordination of the body posture, such adjustments do not

actually reposition the adjusted structures (subluxations) with minute exactness. Specific adjustments

mostly aid the body’s natural responses to settle in the right area, and specific directions of adjustments

will in general help in avoiding injuries of the affected tissue. It is the postural muscles controlled by

neuronal balancing reflexes which reposition the structures. They coordinate all weight-bearing structures

of postural balance into optimal positions against the loads of gravity. When chiropractic physicians

adjust a bone specifically, they will never be able to adjust any structure to a specific location with the

same precision as that of the neuronal coordination of the CNS, which composes ideal weight-bearing

positions against gravity. Thus, specific adjustments will never be able to make bones/joints stay in

specific locations unless the neuronal coordination of the CNS positions them at such locations.

18

Additionally, when the pelvis has assumed perfect TICL horizontality naturally by torsion of the pelvic

bones, including a variety of other natural compensatory twists and bends of curvatures positioning other

postural structures, chiropractic physicians must never try to adjust the pelvis (iliac bone or sacrum) in the

direction of an iliac or sacral listing, because perfect TICL horizontality is assumed as normality by the

normal postural balancing reflexes; such an adjustment will therefore be completely erroneous.

In x-ray images, a pelvis in torsion will be projected according to the proximity of the pelvic structures to

the roentgen film, and therefore an actual physically perfect TICL horizontality naturally assumed by

pelvic bones in torsion will generally be displayed on the roentgen film with a diverging transverse line of

the upper iliac crests. As a rule, Gonstead listings of ASIN and ASEX will therefore be projected onto the

roentgen film as high iliac crests, while listings of PIIN and PIEX will project as low iliac crests.

However, if the TICL is measured as perfectly horizontal, it is simply because it is actually positioned in

perfect TICL horizontality as normality.

Articulations related to the pelvic bones (sacrum, coggyx or iliac bones), which produce torsional position

of the pelvis in order to assume perfect TICL horizontality, may sometimes happen to be overloaded,

causing tissue irritation and subluxation. Articulations of the pelvis may therefore occasionally need

adjustments. Such adjustments must not be delivered directionally in an attempt to change the position of

an iliac bone or the sacrum; on the other hand, they may be made in a specific direction to avoid harming

affected tissue, releasing the protective muscle contraction in the area. Adjustments in the pelvis may be

carried out by the mobilization techniques of ordinary hands-only procedures, TPH therapy, TC therapy,

and fascial release techniques, however, only when the tissues of the pelvis display edema of tissue

inflammations (subluxations). The pelvic adjustments must always be mobilizing, loosening some of the

protective immobilization of the affected tissues.

When letting tissues of adjusted subluxations have about two days of convalescence, which includes

straighter posture and cautious motion, it is not only ordinary chiropractic palpation methods sensing with

the fingertips that will solely indicate whether or not the improvements of the affected tissues have

become satisfactory; nor will a diverging TICL horizontality changed to a perfect TICL horizontality

achieved by a previous treatment and still in horizontal perfection provide such indication. The palpated

changes after therapy will simply indicate information subjectively about any improvement in condition

in patients. Also, a properly maintained horizontal perfection of the TICL will only specify that postural

balance is still optimally coordinated since the previous treatment. Indeed, it is actually the length of time

an imprint in the edema – the indentation of the edematous tissue – lasts in treated tissue that will actually

provide such objective information. Whether or not such an imprint is made by a fingertip, a wooden

19

stick, or even a plastic pen is completely irrelevant. It is actually the length of time that such an imprint

stays in the treated tissue that will truly and objectively describe how an inflammation (edema) has healed

since the previous treatment, as the imprint will show the actual remaining edema left in and around the

connective tissue related to the adjusted subluxation.

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The Cloaked Sense

The previous chapter discussed how sensory receptors register loads and thereby sense the effects of the

force of gravity. Still, sensory receptors belong in a different category of senses than the five special

senses of seeing, hearing, tasting, smelling, and touching. However, there are also other senses, which are

not discussed in general, but are autonomic undetected senses always working in our innate physiology –

for example, excretions of hormones and enzymes into our bloodstream as responses to natural

physiological functions maintaining homeostasis. Still, there are also other undetected senses or

physiological systems, one of which provides us with an ability to sense inflammations through a wooden

or plastic stick (pen); it is of course quite inexplicable but will still be disclosed in this publication.

When coming to terms with the fact that functional physiology in the body is created by a great variety of

senses, it should not at all be astonishing when a new way of sensing inflammatory reactions in tissues

through a wooden stick or any other stick is revealed. Simply think of the quite astonishing sensations

making up the memories in our minds and the effects of sensing providing us with the ability to picture

objects or situations in our heads; those senses are almost beyond belief. Thus, this author’s presentation

of an explanation of sensing inflammations through a wooden stick is really not very obstreperous

compared to the other explanations of the abovementioned senses.

Sensing inflammations through a wooden stick concerns cloaked senses, conceivably in combination with

other senses, but also with an actual physical feeling of a tickling pressure in the tissues of the anatomical

region of the nasal and sometimes ethmoid bones. The author gets this specific sensation particularly in

the suture of the nasal bones (on top of the nose) as changes in a prickling feeling or tickling pressure

when palpating inflamed tissue with the fingertips. The tickling pressure should be created on the

forehand as a steady feeling of pressure without change. This feeling may first be obtained e.g. by holding

the tip of the tongue against the bones in the upper part of the mouth, creating a particular steady

sensation of tickling tissue pressure without changes. Later, when the examiner has become experienced

in producing said steady tickling pressure, he/she may simply relax the facial muscles, creating the same

tickling pressure used for this type of palpatory sensing. The only variation in this tickling pressure

should be felt when sliding the fingertips over affected (inflamed) tissues with a very light caressing

stroke; then, a physical change of increased tickling pressure (prickling) may be felt just as the fingertips

or wooden stick slide over the affected area. Said increased sensation (change in the tickling pressure)

may sometimes be felt in the tissues of the nasal, ethmoid, maxillary, or palatine bones (individual

21

feelings) when stroking the fingertips over an area with inflamed tissues. However, a few may also feel

such sensations in other parts of their body.

When sliding or stroking the fingertips (or wooden stick) over a particular anatomical region with

inflamed tissues, a chiropractic physician well-trained in palpatory sensing may be able to feel a tissue

inflammation as a physical sensation of change in difference in strength of the feeling of the tickling

pressure. Although persons performing this type of palpation most commonly feel the tickling pressure

changes in the tissues in close proximity to the suture of the nasal bones while the inflamed tissues are

stroked over, others may feel said tickling pressure in tissues elsewhere, for example in the median ridge

between the maxillary or palatine bones and sometimes in the forehead, especially in between the

eyebrows.

In order to train to use of this type of palpation, a tickling pressure sensation should first be created on the

forehand by putting the tip of the tongue against the superior maxillary bones in the mouth or further back

in between the palatine bones in the cavity of the upper rear mouth. When such a steady tickling pressure

has been created and the fingertips are stroked or slid over affected tissues, the palpating physician may

try to sense a change in the tickling pressure as the fingertips pass over a specific location of tissues with

a small tissue inflammation. This palpation technique will provide a very specific location for any tiny

inflammation. For persons, who are generally trained in the art of palpation, palpatory sensations may

come on very strongly, providing too many indications creating diagnostic uncertainty. On the other hand,

when palpatory sensations are conducted through a wooden stick, the strength of the ordinary tactile

sensations of the fingertips will be much reduced. Thus, by using a wooden stick instead of the fingertips,

the stick will desensitize the strong tactile palpatory feelings conveyed through bare fingertips and

provide a much more specific sensation only for tissue inflammations.

One may imagine that a copper wire may transmit palpatory sensations more accurately than wood, but

apparently this do not have anything to do with leading electromagnetic waves or similar type of waves,

as the same sensations may be achieved with a plastic pen or even a percussion instrument with rubber

tips, which are electric insulators and do not transmit electromagnetic signals at all. Suggestions have

been made that palpatory sensing comparing changes in tickling pressure may be generated mentally.

However, although a steady tickling pressure may be created in certain tissues by the willpower of a

person trained in this type of palpation, actual changes in the tickling pressure cannot easily be mentally

driven when stroking over inflamed tissues. This fact may be strongly confirmed by blindfolding a test

person. In consequence, the reason why transmission of palpatory sensations may take place through

wood or plastic/rubber is still unclear.

22

Using a Wooden Stick

When discussing palpatory sensations felt through an object like a plastic pen or a wooden stick, a

common question has been asked: “Why use a wooden stick when the palpatory touch of fingertips may

be more sensitive and give more answers?” The answer to this question is: “That is exactly the reason; the

purpose of using a wooden stick is just the opposite because it makes physicians less sensitive, and the

palpatory sensations may therefore be more selective and seemingly focus only on the inflamed tissue

sensed through wood. Thus, the palpatory feelings of the touch of fingertips will generally create too

many and too strong sensations and they will therefore create in general uncertainty. On the other hand,

palpatory sensations felt through a wooden stick will generally reveal only the presence of tissue

inflammations.

23

Yet, there are other reasons for using a wooden stick when palpating tissues. A subluxation is a tissue

lesion, meaning that there is the presence of damaged tissues, like small ruptures in the fibrous tissue.

These ruptures are generally due to structural overloads in the tissue (often long term), and such a lesion

(subluxation) will as a rule always be accompanied by inflammation. As mentioned previously,

inflammations always have four cardinal signs; these include heat, redness, swelling, and pain. Because

these four signs always are present together with inflammations, they also always accompany tissue

lesions (subluxations). It therefore becomes a fact that subluxations (lesions) may be physically observed

when leaving a physical mark (imprint) as an indentation in the swollen tissue, which is made by the

pressure of a wooden stick compressing the affected tissues. Of course, such physical marks may also be

made by a fingertip or any other stick (pen); however, a fingertip generally leaves a weaker imprint, and

therefore a wooden stick is preferred.

The wooden stick may be slid very lightly over the skin, and while stroking it over affected tissue, the

tissue will generally show an increased collection of edema, particularly where there is more swelling.

The exact location of the swelling usually relates to the same anatomical region where palpatory

sensations of tickling pressure in tissues also may be felt (most commonly in the nasal/ethmoid regions).

Although the tissue swelling may or may not be visibly observed as edema, some enduring redness may

be spotted, and it will generally remain as redness in the tissue when being worked upon.

The redness of irritation (inflammation) is usually prevalent when using the Trigger Point Hammer (TPH)

or the TriggerCiser (TC) on tissues. This redness indicates the presence of inflammatory reaction in the

tissues. Heat, on the other hand, may be more difficult to sense, but for a long time there have been

clinical instruments available which read the temperatures of skin/tissue. Last but not the least is another

cardinal sign of inflammation, the sensations of pain. Pain may be provoked by pressure or stretching

during palpatory examinations and finding easily provoked pain is as good as finding an inflammatory

reaction.

When using tissue imprints (indentations) made by a wooden stick, such indentations will remain in the

tissue longer than normal if there is tissue swelling. The tissue swelling may therefore physically indicate

whether or not there is more or less inflammation in the tissues, and it is an observable and objective sign

of inflammation. Thus, the observation of an indentation in edematous tissue will actually be more

objective than the subjective sensation of provoked pain, which frequently may be more mentally guided.

Thus, if there is observable swelling in the tissue when starting a treatment, this swelling should have

subsided slightly two days after the treatment; this is objectively observable.

24

Better motion and increased circulation generally reduce the level of pain. Therefore, when chiropractic

treatments are delivered against inflamed tissues, the pain of normal movements before a treatment will

usually always feel instantly better after the treatment. Then again, a few hours or even a day after a

treatment session, the tissues may become a bit more swollen due to irritating physical effects from the

adjusting procedure. However, after two days of healing, these irritations will generally have healed and

the swelling subsided, making most patients feel better in general. Such good feelings after treatments

simply indicate that the treated tissues of subluxated inflamed lesions are healing and getting better.

Feelings of pain may be more objective and simpler to evaluate when the effects of treatments are

evaluated in examinations with a wooden stick, as such a stick may be used for both for sensing

inflammations as well as for making marks in the skin to physically observe subluxations

(lesions/inflammations). Using a wooden stick to make a dent (impression) in the swollen skin/tissue may

also provide a method to measure up the therapeutic effects of the percussion instruments, the TPH and

the TC, to the effects of other therapies. Such evaluations may be done as simple clinical tests, which

more objectively will be able to evaluate any form of therapy as well as the practical diagnostic use of a

wooden stick.

25

Conclusion

Chiropractic palpation is first and foremost used for determining the location of painful anatomical

regions and to qualify the diagnostic importance of the pain felt by patients while on the other hand

medical palpation is more used for palpating organs. However, palpation of organs has several limitations

because they often have limited accessibility and the examinations may be hindered by the surrounding

tissue. Therefore, in order to provide increased precision and correctness of the palpatory examinations,

certain diagnostic apparatuses have in the last decade been added to medical palpatory examinations and

have to certain degrees even been substituted for them. As a result, imaging modalities now more

commonly employ the use ultrasound machines for clinical medical examinations; these are generally

referred to as elastography.

Elastography performed with an ultrasound apparatus may more objectively determine the correct

consistency of tissues, such as elasticity, stiffness/firmness, muscle tone, and range of motion, and

rheumatologists commonly use them. Also, when examining serious diseases, such as cancer,

elastography may be used primarily but also as an addition to the manual palpation of cancer tissue,

which generally will feel harder than the surrounding normal tissue. This also goes for examinations of

diseased liver tissue, as it also will generally feel stiffer than healthier liver tissue. As the result of

ordinary manual palpation may be perceived subjectively, elastography on the other hand may overcome

many of the subjective challenges of manual palpation and improve its benefits by providing more

objective examinations.

Elastography is a relatively new technology using ultrasound apparatuses, but MRI (magnetic resonance

imaging) has also entered clinics over the last decade. Moreover, amongst the newest elastography

methods, computerized palpation (tactile imaging) has entered the scene, as it also measures stiffness.

Computerized palpation is commonly referred to as “mechanical imaging” or “stress imaging” and is used

as an imaging modality translating the sense of touch into a digital image. Computerized palpation or

tactile imaging closely imitates manual palpation by using a probe and may therefore be similar to human

fingers, creating a pressure sensing slightly deformed soft tissue and detecting changes in the pressure

pattern.

Although the aforementioned new methods may enhance ordinary palpatory examinations, both medical

and chiropractic, they may unnecessarily increase the time spent and costs of examinations where

ordinary methods of manual palpation may be quite adequate. These new types of clinical examinations

26

will also be unable to determine inflammatory responses with the same precise exactness as the use of a

wooden stick needed for sensing the tissues and the objective presence of edema for proper therapy.

All chiropractic physicians should presently employ the simple use of a wooden stick when performing

their palpatory examinations and producing indentations to make imprints into edematous skin tissue to

display the objective fact of a presence of swelling, thereby clinically demonstrating whether there

actually is a subluxation with inflamed connective tissue. This fact will also confirm from one treatment

to the next whether or not there has been a reduction in the inflammatory edema after the previous

treatment.

*

It is now more than 50 years since the author, Jens Anders Kjersem, DC, started his chiropractic career at

Palmer College of Chiropractic (PCC). When he first arrived in Davenport, Iowa, USA, in the mid-

sixties, he felt like returning to Norway immediately, as Palmer College (PCC) and the surrounding area

looked quite awful. However, he stayed on, fell in love with chiropractic, and finally graduated as a

Doctor of Chiropractic in March of 1969. He is now a pensioner but is still in practice, writing and

working to help other chiropractic physicians and people in general to understand the basis of

chiropractic. He has therefore published papers available to anyone on the following website:

https://palmer.academia.edu/JensAndersKjersem

*

In August 2015, Dr. Jens Anders Kjersem (the author of this article) returned to Palmer College of

Chiropractic in Iowa again and participated in the 2015 Homecoming Ceremonies. The author was

surprised to see how beautiful the Campus of Palmer University had become since he was there the last

time. Another good thing was also to observe how beautifully the City of Davenport had been cleaned up.

It had been turned into a very good-looking city with a park-like appearance along the Mississippi River.

While visiting the Palmer Campus, the clinical percussion instruments, the Trigger Point Hammer (TPH)

and the TriggerCiser (TC), developed by Dr. Kjersem, were presented. During this presentation

(demonstration), the clinical findings of the 2008 Research Survey showing that all people with a

diverging TICL horizontality may assume a perfect TICL horizontality after chiropractic treatments, was

verified with the Pelvic Angle Indicator (PAI), which measures physical changes in TICL horizontality of

postural balance against gravity. As the horizontal perfection of the TICL may be a reference for

normality of optimal CNS coordination of total posture, said TICL horizontality may in point of fact

subjectively reveal physical changes in postural balance and better alignment relative to gravity before

and after chiropractic treatments.

27

Because said clinical methods and instruments are of great scientific importance for the whole

chiropractic profession, both the PAI and the percussion instruments, including their clinical methods,

ought to be investigated, verified and endorsed by scientific research. According to the findings made in

said clinical survey during the year 2008 (The 2008 Survey has been published in Proving Chiropractic),

physical measurements with the PAI, which are relative to the force of gravity, will beyond doubt prove

the postural effects produced by chiropractic therapy.

While at the 2015 Homecoming Ceremonies at the Palmer Campus, some of the contents in this

publication, The Art of Palpation, were also presented. Although it was demonstrated that a wooden stick

effortlessly may produce an indentation in edematous tissue to observe the effects and grades of

inflammatory lesions, which are relative to the swelling of subluxations, the ability of sensing

inflammations through a wooden stick on the other hand was impossible to confirm and therefore harder

to verify scientifically. However, if future funding will become available by donations from chiropractic

physicians using this palpation procedure, scientific research of its effects may possibly be undertaken.

*

The new diagnostic and therapeutic methods, in particular the use of the PAI, may in the future make

chiropractic a world-leading prophylactic therapy providing the most efficient clinical examinations and

best treatments of postural balance, unsurpassed in treating scoliosis and reducing loads in posture.

When correct postural examinations, including the K-S Test, have been implemented in chiropractic

therapy, chiropractic physicians will no longer have to rely on poor diagnostic measurements of postures

affected by different pressures created by lying on a bench, which press normally balanced postures into

different shapes with altered measurements, thereafter resulting in poor and improper postural

corrections.

*

If chiropractic physicians, professors and college administrators listen, discuss, and talk to each other

more openly and more often, also in general avoid automatically dismissing all new therapeutic methods

not yet accepted in the set of courses at chiropractic colleges, the chiropractic profession will become the

best it has ever been.

*

28

The conclusion of this author’s visit to his alma mater and fountainhead of chiropractic is that the future

in general may be very good for the chiropractic profession if the aforementioned new methods are

evaluated and undertaken research, and thereafter if verified, is implemented into chiropractic.

29